Most People Want to Age at Home - Half Think They Can

As you approach your 50s, and surely once you are in your 50s, you start imagining life after retirement. Will you downsize your home, or is your home a place you can live comfortably in the decades ahead?

One part of the retirement equation, other than funding retirement, is the question of where you will live, and will you have the ability to age in place?

Most families today have experienced a parent needing help with daily living activities as they become older. Their health and bodies started declining, and they became more dependent on others. 

Few Want to Be Dependent on Family

At least one of your parents probably needed someone's help and even more formal in-home care or assisted living or nursing home care. This care is costly and will continue to get even more expensive in the decades ahead due to the increasing demand for care and higher labor costs.

You or one of your siblings may have already become caregivers for one or both of your parents. Your parents didn't enjoy being dependent on anyone, especially their children. There may have been some conflict within the family on whose job it would be to provide care for Mom or Dad in some cases.

Meanwhile, your parents probably wanted to stay home. Unless there was a plan, many people get forced into more formal facility care. 

Aging in Place in Your Home

So how about you? Many surveys, including an AARP survey, show that people prefer to stay in their current home as long as possible. The survey of adults aged 50 and older showed that 77% of the respondents agreed with the statement, "I'd really like to remain in my community for as long as possible,"

Almost the same number of people wish to remain in their current home; however, only about half think they'll be able to stay put. There are several reasons for this:

• Limited financial resources.
• Lack of available family to provide care.
• Unavailable or untrustworthy informal care services to provide services.
• No Long-Term Care Insurance.

In-Home Care Isn't Cheap

The costs of long-term health care services, even at home, are costly. For example, in Des Moines, Iowa, one year of in-home care averages today $57,200 a year. Three years of care would cost at least $172,000 over the three years (based on a 44-hour week). 

What happens in twenty-five years? The same three years of in-home care would cost over $400,000. The costs of assisted living facilities, memory care facilities, and nursing homes will be even more - Iowa Long-Term Care | LTC News.

The costs do vary depending on where you live. The LTC NEWS Cost of Care Calculator will show you both the current and future cost of care in your area - Cost of Care Calculator - Choose Your State | LTC News.

Health Insurance, Medicare, or Medicaid - an Answer?

No. 

Health insurance, including Medicare and available supplements, pay very little if any long-term care services. They will pay for a limited amount of skilled services in a facility or at-home recovery following surgery—otherwise, nothing. Most long-term health care services are custodial - meaning help with daily activities or supervision due to memory loss. 

Medicaid will only pay for long-term health care if you have little or no income and assets. Usually, it will only pay for a nursing home that accepts Medicaid. 

Medicaid Waivers

Some states with waivers are allowed to offer some flexibility on care delivery if you qualify for Medicaid benefits. 

Waivers granted by the federal government allow the state to "waive" certain rules limiting how long-term health care must be delivered. States with a waiver can expand benefits to specific groups of people, make certain benefits available only to select groups, limit coverage to specific geographic regions within the state, and test other ways to run their Medicaid programs.

These states have extended more options for those on Medicaid, including adult day care, respite care, and in-home care & homemaker services. However, the Medicaid program requires you to have little or no income and assets, and you are not allowed to "give away" assets to qualify for Medicaid. 

There is also a question of the quality of care on Medicaid because of the very low government reimbursement to the provider. 

Family Probably Not an Answer for Care

If your family doesn't live near you, they can't provide your future care unless you move. Even if they do live nearby, would they be able to juggle the role of being your caregiver with their jobs and family responsibilities? That is assuming they were able to handle a very difficult and demanding job.

Family caregivers are untrained and usually unprepared for the role. The job is physically and emotionally challenging. It often brings conflict between the care recipient and the caregiver - not to mention the conflict between the caregiver and other siblings and family members. 

Most research indicates that people would prefer their adult children to remain family instead of burdened with being their caregiver. The caregiving job changes the relationship between parent and child, and this change is usually uncomfortable for both. 

Unlicensed and Untrained Informal Care

The availability of informal care varies depending on where you live. These 'informal' caregivers avoid the licensing, training, and background check requirements that most states place of caregivers. 

You want a caregiver that is trained for the job to maintain your health and safety. Stick with pros. 

No Long-Term Care Insurance Available

One of the first things any long-term health care provider asks when you or a family member calls is, "Is there Long-Term Care Insurance in place?"

You cannot purchase Long-Term Care Insurance at some ages and not when you have poor health or already require care. Unfortunately, waiting until you need care is not a planning option.

Generally, you purchase Long-Term Care Insurance in your 40s or 50s when you still enjoy reasonably good health, and premiums are low. If you wait - you may have waited too long.

With LTC Insurance, you will depend on your own savings, family, or perhaps, when you have no money left, Medicaid. 

The Goal is to Remain at Home

If you want to avoid going into a facility, especially a nursing home and avoid pushing your family into caregivers, you should start planning now, before you get older and retire. 

Long-Term Care Insurance is an affordable option for many American families. Sure, few people 'like' buying insurance. However, without a Long-Term Care Insurance policy, you place all the financial, physical, and emotional stress on your family and finances. You give up choice and control.

Even if you have substantial financial resources, you cannot time the market and future care needs. One of your adult children would have to decide which account to liquidate and arrange and pay for your care. The cost of care is much more than the insurance, and then your family would have time to be family.

There are lots of things to think about after you get past age 45. If you want to stay in control and avoid dependency, then looking into LTC Insurance is prudent.